1800例化脓性肝脓肿临床特点总结。

IF 2.3 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY European Journal of Gastroenterology & Hepatology Pub Date : 2024-12-09 DOI:10.1097/MEG.0000000000002906
Yu Tian, Diandian Hao, Jialin Du, Hui Wang, Xiaoyu Wen
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引用次数: 0

摘要

目的:总结化脓性肝脓肿(PLA)患者的临床及微生物学特点,探讨PLA合并肝外迁移感染(EMI)的临床特点。方法:回顾性分析吉林大学第一医院2019年1月至2023年12月收治的1800例解放军患者的临床资料。患者根据有无EMI分为两组:有EMI和无EMI。两组患者的临床特征和预后分别采用秩和检验和卡方检验对连续资料和分类资料进行比较。结果:PLA患者以男性为主(65.56%),平均年龄60岁。脓肿主要位于右肺叶(64.83%),单发多见(68.17%)。肺炎克雷伯菌为主要病原菌(68.46%),耐多药菌株占9.50%。多数患者经有效治疗后好转(96.17%)。与非EMI组相比,EMI患者更年轻,住院时间更长,脓肿较小,糖尿病和脑血管疾病的发病率更高,预后较差。结论:PLA最常见于中老年男性,常表现为右侧肺叶单发脓肿,常伴有糖尿病。大多数患者经适当的抗生素治疗和超声引导引流后恢复。PLA患者合并EMI通常预后较差,需要特别注意。
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Summary of clinical features of 1800 cases of pyogenic liver abscess.

Objective: This study aimed to summarize the clinical and microbiological characteristics of patients with pyogenic liver abscess (PLA) and to explore the clinical features of PLA with extrahepatic migratory infection (EMI).

Methods: A retrospective analysis was conducted on clinical data from 1800 PLA patients at Jilin University First Hospital from January 2019 to December 2023. Patients were divided into two groups based on the presence of EMI: with EMI and without EMI. Clinical features and prognoses of the two groups were compared using rank-sum tests and chi-square tests for continuous and categorical data, respectively.

Results: PLA patients were predominantly male (65.56%) with an average age of 60. Abscesses were mainly located in the right lobe (64.83%) and were often single (68.17%). Klebsiella pneumoniae was the primary pathogen (68.46%), with 9.50% of strains being multidrug-resistant. The majority of patients improved with effective treatment (96.17%). Compared with the non-EMI group, patients with EMI were younger, had longer hospital stays, smaller abscesses, and a higher incidence of diabetes and cerebrovascular disease, with poorer prognoses.

Conclusion: PLA is most commonly observed in middle-aged and elderly males, often presenting as single abscesses in the right lobe, with diabetes as a frequent underlying condition. Most patients recover with appropriate antibiotic treatment and ultrasound-guided drainage. PLA patients with EMI generally have poorer outcomes and require special attention.

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来源期刊
CiteScore
4.40
自引率
4.80%
发文量
269
审稿时长
1 months
期刊介绍: European Journal of Gastroenterology & Hepatology publishes papers reporting original clinical and scientific research which are of a high standard and which contribute to the advancement of knowledge in the field of gastroenterology and hepatology. The journal publishes three types of manuscript: in-depth reviews (by invitation only), full papers and case reports. Manuscripts submitted to the journal will be accepted on the understanding that the author has not previously submitted the paper to another journal or had the material published elsewhere. Authors are asked to disclose any affiliations, including financial, consultant, or institutional associations, that might lead to bias or a conflict of interest.
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